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The basics:

• Health care networks like HMH and Atlantic Health are expanding virtual and hybrid care options
• ‘Hospital at Home‘ models provide inpatient-level care remotely
• Telemedicine, AI as well as urgent and ambulatory care centers improve access and reduce costs

Driven by growing demand for convenience, accessibility and cost-effective models that do not compromise quality, health care institutions are meeting patient needs with services outside of traditional settings. As a recent Deloitte report noted, “Health care services that are accessed digitally at home and outside the traditional nine-to-five clinic hours are becoming increasingly important to consumers as they prioritize convenience.”

One of the most significant changes is the rise of telehealth and virtual care, according to Hackensack Meridian Health Chief Physician Executive Dr. Daniel Varga. “Hospitals are now offering virtual consultations, allowing patients to connect with health care providers from the comfort of their homes,” he explained. “This approach not only saves time and reduces transportation costs but also ensures that patients receive timely medical advice.”

HMH is delivering on that promise, he added. “We collaborated with K Health – an AI-driven primary care company – to launch HMH 24/7, a new AI-driven solution that connects patients to primary care 24/7, through a seamless integration of virtual and in-person care. This allows patients to access virtual care as a bridge between in-person visits, almost like having a primary care physician by your side whenever you need their services.”

HMH and other hospitals are also expanding their physical presence through alternative sites for care. “Urgent care centers, ambulatory surgical centers, and hybrid models combining brick-and-mortar facilities with virtual services are becoming more common,” Varga detailed. “These sites can offer a range of services, from basic lab imaging and physician access to more complex radiology assessments and mental health support.”

In March, HMH partnered with Amazon to launch Amazon One Medical in Jersey City. “Located at Edgewater Towne Center, this office is the first of three Amazon One Medical locations planned to open this year in partnership with HMH,” he said. “This high-quality hybrid virtual and in-person primary care approach will expand access to comprehensive care for New Jersey residents, treating conditions from preventative care to addressing immediate concerns like cold and flu, and managing chronic conditions like diabetes. The Amazon One Medical partnership is designed to improve the patient experience at every touch point, with features like thoughtfully designed offices in convenient locations, same and next-day appointment availability, drop-in lab services, and appointments that provide ample time between patients and their providers.”

The Amazon partnership is the latest iteration of a “beyond the hospital” strategy that launched more than a decade ago, Varga added. “For years, HMH has set up assets beyond the hospital across the state, including urgent care centers and urgent care-plus centers that offer basic lab imaging, physician access, complex radiology assessments, mental health support and other services,” he explained.

At your convenience

The “Hospital at Home” model is another innovative approach that allows patients to receive hospital-level care in their own homes. “This model uses a combination of in-person visits from caregivers and remote monitoring by physicians and nurses,” Varga explained. “Vital signs, blood pressure and oxygen saturation levels are continuously monitored, ensuring that patients receive the same quality of care as they would in a hospital setting. This approach not only frees up hospital beds for urgent surgical patients but also creates capacity for more patients to be served at home.”

Despite the benefits, there are several challenges associated with these new care models. “Financially, the ‘Hospital at Home’ model relies on Centers for Medicare & Medicaid Services waivers [which suspended Medicare requirements for nursing services to be provided on premises 24 hours a day, seven days a week] to secure payment, which can be difficult to obtain,” he observed. “And logistically, the acceptance of these models by both doctors and patients is crucial. Some patients may feel more comfortable in a traditional hospital environment, while others may lack the necessary home environment for remote care. But technological advancements – such as AI-driven risk stratification and continuous home care monitoring – are helping to overcome these challenges by providing valuable insights and improving the quality of remote care.”

HMH and other institutions are also investing in ambulatory surgical centers, “which allow patients to undergo surgeries and return home the same day,” Varga said. “These centers are often operated in joint ventures with doctors, providing site-neutral care that is especially beneficial in light of Medicare and Medicaid cuts. This approach meets patients where they want to be, offering urgent care and surgical services outside of traditional hospital settings. While challenges remain, the continuous evolution of technology and health care practices promises a future where patients can access high-quality care wherever they are.”

Other institutions are also getting the message. Driven by a confluence of economic, regulatory and consumer preferences, hospitals are increasingly providing services to patients outside of traditional hospital sites, according to Dr. Steven Sheris, executive vice president, chief physician executive for Atlantic Health System and president of Atlantic Medical Group. He says AHS is leveraging technology and innovative care models to enhance patient access and reduce costs.

“The goal is to deliver patient-centered care in the right setting and at the right time,” Sheris explained. “Alternative sites of care, extending clinic hours to include evenings and weekends, and offering virtual and digital health options can help reach a broader consumer base while potentially lowering out-of-pocket costs and indirect costs, such as transportation and time away from work.”

One notable advancement is the development of urgent care centers and ambulatory surgery centers. “These facilities offer a range of services that were traditionally provided in hospitals, such as minor surgeries, diagnostic tests, and urgent medical care,” noted Sheris, who pointed out that Atlantic Health has advanced urgent care facilities in various locations, including Mountain Lakes, Paramus and Clark; with extended hours at Atlantic Medical Group sites, including evenings and weekends.

“By shifting some services to alternative sites, health care providers can reduce overhead costs and improve patient access to care. Atlantic Health System in particular has developed an urgent care and overall ambulatory footprint strategy,” he continued. “Medtech has helped us to find new ways to deliver care. In some cases, when a patent previously had to be sent to the emergency department, they can now be successfully evaluated and treated at an offsite urgent care location, at home or at an ambulatory setting that provides minor surgical procedures — often with extended hours and recovery options.”

Telemedicine and remote patient monitoring have played crucial roles in this transformation. “These and other technologies enable patients to receive medical consultations and monitoring from the comfort of their homes, reducing the need for hospital visits,” Sheris said. “Remote monitoring of heart rhythms, weight and blood sugar levels, which previously required hospital beds, can now be done at home. When appropriate, many people prefer to be treated at home with their family, or on the jobs. This approach not only lowers costs but also enhances patient satisfaction.”

Some obstacles remain

But expanding alternative care sites of care does encounter some obstacles. “One barrier is the investment that the new form of care requires,” said Sheris. “And the existing government and insurance reimbursement system primarily focuses on illness rather than on prevention and wellness. Under the current system, we are making current-period investments with payoffs that range from five to 10 years.”

Unlike New Jersey and other states that basically follow the traditional approach to medical reimbursement, “The Kaiser Permanente model in California, and Intermountain Health care in Utah are examples of successful implementations of alternative care models that focus on prevention and reimburse health care providers accordingly,” according to Sheris.

Despite these challenges, Sheris said the shift toward alternative sites of care is gaining momentum. “As hospitals continue to expand their services beyond traditional sites, the focus remains on delivering evidence-based, patient-centered care,” he observed. “This evolution underscores the importance of adapting to changing health care dynamics and meeting the needs of diverse patient populations through a variety of approaches, including virtually and in-person, to fit patient needs.”

He noted, though, that, “Socio-demographic and other barriers are real, and we will have to identify those pockets and adjust. The answer is definitely not a homogenous model.”

But Sheris believes that the health care system may be at a tipping point, as patients demand higher-value care. “There is an economic imperative as patients have to bear more out of pocket expenses,” he warned. “People realize the current model is not sustainable. The change process is slow but I believe the current fee-for-service approach is not sustainable and will eventually go away, to be replaced by an improved design.”